SynthesisJournal of the American Heart Association2025
Holter Monitor Rhythm Parameters in Healthy Infants, Children, and Adolescents: Defining Reference Limits With Meta-Analysis.
Synthesis in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Pediatric premature atrial contractions: Clinical characteristics, diagnosis, and management-A literature review.American heart journal plus : cardiology research and practice · 2026Review
- Cardiac rhythm development: A wearable device index of risk for physical and mental illness in adolescence.medRxiv : the preprint server for health sciences · 2026Article
- Beyond symptoms: Rhythm surveillance in congenital heart disease.Heart rhythm O2 · 2026Article
- Significant Cardiac Rhythm Disturbances in Infant Bronchiolitis: A Holter-Based Prospective Analysis.Journal of pediatrics. Clinical practice · 2026Article
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5 authors.
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Abstract
backgroundAmbulatory electrocardiography has been in clinical use for 5 decades. However, reference limits for rhythm parameters in healthy infants, children, and adolescents have not been adequately defined. We sought to determine these reference ranges using meta-analysis of existing published studies of 24-hour Holter monitoring in healthy pediatric populations.
methodsMultiple literature databases were searched from 1969 to May 2024 for relevant studies. Data extraction and analysis were completed according to the Meta-Analysis of Observational Studies in Epidemiology guidelines. The prevalence of cardiac ectopy and conduction delays along with mean±SD of heart rates were obtained and grouped by the following age ranges: neonates (birth to 4 weeks), older infants (1-12 months), younger children (1-6 years), older children (7-12 years), and adolescents (13-18 years). Ninety-five percent reference ranges for all rhythm variables were estimated in each age group.
resultsForty-five studies including 3886 participants were identified and analyzed. Minimum, average, and maximum heart rates during Holter monitoring decreased with age as expected. Prevalence of transient first-degree atrioventricular block and Wenckebach second-degree atrioventricular block increased with age to around 14% in adolescence. Prevalence rates for any premature atrial complexes and premature ventricular complexes were also highest in adolescence at 50% and 29%, respectively. The upper limits for the number of premature atrial complexes per day were 150 in infants and 50 in the older age groups and for premature ventricular complexes were 50 in all age groups.
conclusionsHolter monitor age-related reference limits for healthy infants, children, and adolescents are proposed.
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